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In the Safe Implementation of Treatment in Stroke-International Stroke Thrombolysis Registry, thrombolysis in 502 such cases from 2010 through 2014 was not associated with greater risk of symptomatic intracerebral hemorrhage than seen among the 44,875 treated within a 4.5-hour window (adjusted OR 1.09, 95% CI 0.44-2.67)
Nor was there a significant difference in prospects of functional independence (adjusted OR 0.79, 95% CI 0.56-1.10, for modified Rankin Scale score of 0-2), researchers reported.
The other study was an analysis of baseline data from the first 1,000 patients in the WAKE-UP trial randomizing patients to placebo or thrombolysis based on MRI characteristics, such as mismatch between infarct on diffusion-weighted imaging and fluid-attenuated inversion recovery.
"Almost half of the patients with unknown time of symptom onset stroke otherwise eligible for thrombolysis had MRI findings making them likely to be within a time window for safe and effective thrombolysis," the researchers reported. "Patients with daytime onset unwitnessed stroke differ from wake-up stroke patients with regards to clinical characteristics but are comparable in terms of MRI characteristics of lesion age."